Medically Reviewed By: Dr Paul Lim – MBBS, M.Med (Int Med), MRCP (UK), FAMS (Cardiology)
A cardiologist — also called a heart specialist — is a doctor who specialises in the heart and blood vessels. Some people are sent by their GP; others come directly because something does not feel right, or because they know they are at risk. The 12 reasons below fall into three groups — symptoms you should not ignore, risk factors that quietly raise your risk, and warning signs a doctor or a test has already found. If any of them apply to you, it is worth being assessed.
A cardiologist is a doctor who specialises in diagnosing and treating conditions of the heart and blood vessels. In Singapore, the term “heart specialist” is commonly used to mean the same thing. A cardiologist first qualifies as a doctor, then completes several further years of specialist training in cardiology — and some subspecialise further, as Dr Lim has in heart rhythm disorders, working as a cardiac electrophysiologist.
A cardiologist assesses symptoms that may be coming from the heart, interprets tests such as the ECG, echocardiogram, and stress test, measures your risk of future heart problems, and manages heart conditions with lifestyle advice, medication, or minimally invasive procedures. A cardiologist does not perform open-heart surgery — that is the role of a cardiothoracic surgeon, to whom a cardiologist refers on the rare occasions it is needed.
Senior Consultant Cardiologist & Cardiac Electrophysiologist
Dr Paul Lim is a Senior Consultant Cardiologist who assesses heart symptoms and cardiovascular risk — using clinical examination, ECG, echocardiography, treadmill stress testing, and CT coronary imaging — and who subspecialises in heart rhythm disorders. He completed advanced fellowship training at Barts Heart Centre, London under Singapore’s HMDP award.
Seeing a heart specialist is worthwhile for more than just your symptoms — here is what you get out of it.
Many heart problems build up silently, before any symptoms — the rationale behind cardiovascular screening. Found early, they are far easier to manage.
A cardiologist works out whether your heart is behind your symptoms, and measures your risk of future problems.
If the heart turns out not to be the cause, that is a useful result — it points you towards the real explanation.
You do not need a referral to be seen, though many patients are sent by their GP or another specialist.
The twelve reasons below are the situations where a heart assessment is most often worthwhile — grouped into symptoms you should not ignore, risk factors that raise your risk, and warning signs a doctor or a routine test has already found. This is a general guide, not a diagnosis; if any apply to you, the next step is a conversation with a doctor about your own circumstances.
These are the symptoms that most often turn out to be the heart. None of them is proof of a heart problem on its own, but each is a reason to be checked rather than to wait and see.
Chest tightness, pressure, or heaviness — especially when it comes on with exertion and eases with rest — can mean the heart muscle is not getting enough blood. Chest pain can also be a sign of a heart attack. Because the cause cannot be told from the feeling alone, new, severe, or exertional chest pain should be assessed without delay. A stress test or CT coronary angiogram is often used to look into it.
Feeling unusually short of breath, noticing a racing, pounding, or skipping heartbeat, or having episodes of light-headedness can point to an abnormal heart rhythm, reduced blood flow through the arteries, or heart failure. Palpitations and dizziness together are especially worth checking, as they can be linked.
Swelling in the legs or ankles, breathlessness when lying flat, waking at night short of breath, worsening fatigue, or needing more of your water tablets (diuretics) than before can all suggest the heart is struggling to pump effectively. This combination of symptoms deserves prompt review to find the cause and start treatment.
Important: if a symptom is happening right now and is severe — crushing chest pain, sudden severe breathlessness, fainting, or a racing heartbeat with chest pain — call 995. The reasons on this page are about deciding when to book an assessment, not about what to do in an emergency.
Recognise any of these symptoms? Find out whether your heart is the cause.
These do not usually cause symptoms, which is exactly why they matter. Each one raises the long-term risk of heart disease, and each is a reason to have your heart risk measured — even if you feel completely well.
Blood pressure that stays high despite treatment, needs several medicines, or is difficult to control benefits from specialist assessment. Sustained high blood pressure strains the heart and arteries over time, and is one of the most important treatable causes of heart disease and stroke.
Diabetes is strongly linked with cardiovascular disease, and poorly controlled blood sugar substantially raises the risk of coronary artery disease and heart failure. Because that risk builds quietly, people with diabetes benefit from having their heart assessed even before any symptoms appear. An HbA1c blood test is used to track control.
Raised cholesterol contributes to the build-up of fatty plaque inside the arteries and may need specialist management — particularly when it is very high, runs in the family, or is already causing narrowing. Additional markers such as apolipoprotein B and lipoprotein(a) can refine your true risk beyond a standard cholesterol panel.
Smoking is one of the most important preventable causes of heart disease, and a major contributor to high blood pressure and the furring-up of the arteries. A current or past smoking history is a reason to have your heart checked — and stopping, at any age, meaningfully lowers your risk from that point on.
Some heart conditions run in families, especially early-onset disease — a heart attack or heart disease before the age of 55 in a father or brother, or before 65 in a mother or sister. A strong family history is a reason to be assessed even if you feel well, because it raises your own risk regardless of your other numbers.
Kidney disease is closely tied to high blood pressure and arterial disease, and significantly increases the risk of heart problems. The heart and the kidneys influence each other, so reduced kidney function is itself a reason to have the heart assessed and cardiovascular risk factors managed closely.
Sometimes the reason to see a cardiologist is something someone else has already spotted — on examination, or on a routine test done for another purpose. These findings should not be left unexplained.
Narrowing of the arteries in the legs — which can cause aching calves when you walk — or in the carotid arteries of the neck signals that the coronary arteries are likely affected too, because it is the same disease process throughout the body. Finding it in one place is a reason to assess the heart.
If a doctor hears a murmur or an unusual heart sound through the stethoscope, it can indicate a valve problem or a structural issue with the heart. This is straightforward to investigate with an echocardiogram, an ultrasound scan that shows the valves and the pumping chambers in detail.
An abnormal ECG, echocardiogram, or stress test — or a raised cardiac blood marker — found at a health screening or before surgery should be reviewed by a cardiologist. The aim is to work out what the result actually means for you, and whether anything needs to be done about it.
Assessment is tiered: it starts simple, and goes further only when the story or the findings warrant it. Not everyone needs every test — for many patients, a consultation, an ECG, and an echocardiogram give a clear answer, and further noninvasive testing is added only when it will change the plan.
Dr Lim will ask about your symptoms, your risk factors, your medications, and your family history, then examine you — listening to your heart and lungs and checking your blood pressure and pulses. In heart assessment, the history is the most informative part, and it directs everything that follows.
A 12-lead ECG takes a few minutes and records the heart’s electrical activity, showing rhythm problems, strain, or evidence of a previous event. A Holter monitor extends this over a day or more if your symptoms come and go.
An echocardiogram shows the heart’s structure, valves, and pumping function. If your symptoms come on with exertion, a treadmill stress test reproduces the trigger under monitoring to see how the heart behaves under load.
A CT coronary angiogram gives detailed pictures of the coronary arteries and is particularly good at ruling out significant narrowing, while a CT calcium score quantifies your risk. Blood tests for cholesterol, blood sugar, and organ function complete the picture. Where you have no symptoms but want your baseline measured, a heart screening packages these tests together.
Contact us to schedule a consultation or to find out more about our cardiac services.
Answers to the most common questions about when to see a cardiologist, whether you need a referral, and what to expect at your first appointment.
See a cardiologist if you have symptoms that could come from the heart — chest pain or pressure, unusual breathlessness, palpitations, dizziness or fainting, or swelling in the legs — or if you have risk factors that raise your heart risk, such as high blood pressure, diabetes, high cholesterol, a smoking history, chronic kidney disease, or a family history of early heart disease. You should also be reviewed if a doctor has heard a heart murmur, found peripheral arterial disease, or picked up an abnormal ECG, echocardiogram, stress test, or cardiac blood marker. Symptoms happening right now that are severe or come with sweating, fainting, or severe breathlessness are an emergency — call 995 rather than waiting for an appointment.
You do not need a referral to book a consultation — you can arrange to see a cardiologist directly. Many patients are referred by their GP or another specialist, and a referral letter with your history and any recent test results is helpful because it saves repeating tests, but it is not required to make an appointment.
A GP (general practitioner) is your first point of contact for all health concerns and manages common heart risk factors such as blood pressure and cholesterol. A cardiologist is a doctor who has trained specifically in diagnosing and treating conditions of the heart and blood vessels, and who has access to tests such as echocardiography, stress testing, and CT coronary imaging. A GP and a cardiologist work together: your GP manages your day-to-day care and refers you when a heart problem is suspected or needs specialist assessment.
Yes. Many heart conditions build up silently for years before they cause symptoms, so a heart assessment is worthwhile if you have risk factors even when you feel well — for example diabetes, high blood pressure, high cholesterol, a smoking history, or a family history of heart disease before the age of 55 in a male relative or 65 in a female relative. A heart screening establishes your baseline risk and can pick up problems early, when they are easiest to manage.
There is no single age that applies to everyone — it depends on your symptoms and your risk. Anyone with heart-related symptoms should be assessed at any age. For people without symptoms, a heart screening is commonly considered from around the age of 40, and earlier if you have a family history of early heart disease or risk factors such as diabetes, high blood pressure, or high cholesterol. The right timing for you is a decision to make with a doctor who knows your history.
The consultation starts with a detailed history — your symptoms, your risk factors, your medications, and your family history — followed by a physical examination that includes listening to your heart and checking your blood pressure. An ECG is usually done on the day. Depending on the findings, further tests such as an echocardiogram, a treadmill stress test, a Holter monitor, or CT coronary imaging may be arranged. You will leave with an explanation of what is and is not likely to be going on, and a clear plan for any next steps. You can see the cardiology consultation fees in advance.
